Thursday, October 27, 2016



November Bombshell

Wikileak surprises keep coming, but biggest bombshell may be premium increases, due to kick in on November 1.

Premiums will go up an average of 25% but will increase dramatically in some states – Arizona 116%, Oklahoma 69%, Tennessee 63%, Minnesota 59%.  

These increases are significant because  Obama promised premiums would decline by $2500 per family and consumers would be able to keep their doctor and health plan.  Neither promise has worked out.

So we are left with this situation- broken promises and narrow choices of doctor and premium and deduction spikes the middle class cannot afford.

Bill Clinton says ObamaCare is “crazy” with 25 million  Americans more uninsured being subsidized but many more millions suffering double, triple, or quadruple  unaffordable care.    Governor of Minnesota,   Mark Dayton,  formerly a fervid ObamaCare supporter,  says the health law is no longer affordable and must be changed, even repealed.

What’s gone wrong?

Dubious. Even false assumptions.

Assumptions

One,  ObamaCare would be a step forward towards universal health care.   Instead studies in two states,  Vermont and Colorado,  have shown universal care in their states would be exorbitant and unacceptable to their citizens.

Two,  ObamaCare would prove to popular with public.  Instead more than 500 polls have shown only three polls indicating favorability among the public.

Three,  one could tinker with insurance risk factors, such as excluding those with pre-existing conditions from calculating  premiums  and making it impossible to charge women more than women.  So, we have an unbalanced system with soaring premiums.

Four,  millenials would join health exchanges and pay costly premiums rather than fork up $695 for not being covered.   Wrong again.   Premiums cost twich as much as the penalty. As one millennial said,  “We may be young but we are not stupid.”

Five,   by crowding doctors into Accountable Care Organizations and having those organizations  being led by primary care doctors beholden to hospitals,  one could save Medicare money.  This hasn’t worked out yet,  and many of the original “Pioneer ACOs: have dropped out of ACO program,  including its poster child,  Dartmouth.

Six,   Doctors would accept  pay reductions, based on routine EHR data measuring quality outcomes and proper diagnostic and procedural use,  because they could not do otherwise,  i.e. participate in Medicare, Medicaid, and health exchange programs.   Wrong.   Many doctors, 10% to 50%, are not participating in programs  or are switching to direct pay,  concierge, medicine to avoid 3rd party regulations,  penalties, and hassles.

And so it goes.   Insurers and doctors are withdrawing from most markets.    Doctors are not accepting federal programs, or or are slowing services for federal sponsored patients.  Talk of a death  spiral of ObamaCare is rampant,  and, if Trump is elected,  ObamaCare will be repealed.   If Clinton becomes president,  she promises big changes, or a public option, as a giant step forward towards total government control.

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